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General NPI Number Information
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NPI Number | 1093890097
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Entity Type | Individual
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Provider Name | BRADLEY DAVIS TEMPLETON M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 702 13TH ST
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-4075
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Country | US
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Telephone | 336-667-5296
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Fax | 336-667-0864
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Provider Business Mailing Address
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Address Line | PO BOX 1348
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-1348
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Country | US
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Telephone | 336-667-5296
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Fax | 336-667-0864
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24818
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License Number State | NC
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